When you stop to think about it, it is truly amazing that infants and young children learn language without conscious teaching, but simply by "soaking it up" as they listen, watch, and imitate those around them. As if by magic, the average 5-year-old child uses and understands a multitude of words. He/she can combine the words to decipher and generate lengthy sentences; add prefixes, suffixes, and various tenses; change the word order or the intonation to change the meaning; and add gesture and body positioning to emphasize his/her point. It is a complicated system that we take for granted, and, for some children, early language development can be challenging.

What is language?

It is easiest to explain what language is not-language is not speech. Speech refers to the developmental process known as articulation. Sounds, syllables, and words are formed when the vocal chords, tongue, jaw, teeth, lips, and palate change the stream of air that is produced by the respiratory system. The English language is a complicated system that can be defined by the following units: phonology, morphology, syntax, semantics, and pragmatics. Basically, the English language is governed by a set of rules. For some children, understanding (receptive language) and using (expressive language) these rules appropriately can be difficult. A significant delay in receptive and expressive language skills may be referred to as a language disorder. It is important to note that language processing and cognition are two different issues. Many very bright children have difficulty with language, and may simply require a "boost" in language skills from a qualified speech language pathologist.

What does a language disorder look like?

Because there are so many different aspects to language, not all language disorders look alike. For example, obvious delays in expressive language are evident in a 2-year-old child who has a vocabulary of less than 50 words, or in the 3-year-old child who cannot combine more than two words together. Some children with language disorders progress through their toddler years in a typical manner, but have difficulty when they are older using salient language or maintaining the topic of conversation. Other children may have difficulty with receptive language skills and appear to always misunderstand what has been said to them or be considered "poor listeners." They may have problems with attention or following directions. Language problems may surface in the aspect of pragmatics, such as the child who always seems to say the wrong thing at the wrong time, or who has limited social skills with his/her peers. Language difficulties may be apparent when children have difficulties in reading and writing, and even in math.

What causes a language disorder?

True, kids not only "say the darndest things," but they say them in such a cute way. What is not The cause of a language disorder depends on the type of delay. Sometimes, it can be pinpointed to an obvious event in the child's life, such as a brain injury. However, many language disorders have no known cause. Although specific parts of the brain govern specific language skills, it is often impossible to determine why a child has difficulty with a certain aspect of language.

Who do I talk to about this first?

Parents should contact their child's doctor to discuss the possibility of consulting with a certified speech language pathologist if they are concerned about their child's language skills. Early intervention is considered the "best practice," and it is especially important when the child appears to be having any type of difficulty with gestural, spoken, or written communication.

What is a speech language pathologist?

A speech language pathologist (commonly know as a speech therapist) holds a master's degree or doctorate, and is trained to evaluate and treat speech, language, and learning issues. Some speech language therapists have additional training in feeding, augmentative communication, and other highly specialized areas. Some therapists work strictly with adults, while other therapists work with children. It is important to ask the therapist if he/she has experience with language disorders in children. Parents should always be sure that the therapist is certified by the American Speech-Language Hearing Association and is licensed by their state. A skilled speech language pathologist will assess the child's skills, while consulting with other professionals to rule out other conditions that may be impacting language skills, such as hearing loss, sensory integration problems, or emotional disturbances.

Therapy sounds like drudgery -- my child will hate it!

Surprisingly to many parents, speech language therapy does not have to be a dreaded task. In fact, it does not feel like "therapy" to many children. Speech language pathologists incorporate group activities, games, movement, computers, crafts, and even cooking into the therapy sessions to facilitate language development.